Dental savings plans vs. dental insurance, explained simply

The one-sentence version

Dental insurance pays part of your dental bill. A dental savings plan (also called a discount plan) doesn't pay anything. It gets you a lower price, and you pay that lower price yourself.

Both can help. They just work differently.

How dental insurance works

You pay a monthly premium. When you get care, the insurance company pays a share of the cost and you pay the rest. When HealthCare.gov describes comparing dental plans, it points you to each plan's costs, copayments, deductibles and covered services, and those details are where plans differ the most.

One big thing to watch: waiting periods. HealthCare.gov warns that separate dental plans can have waiting periods before they cover services for adults. During that time you still pay premiums, but the plan won't cover those services yet. If you need work soon, ask about waiting periods before you enroll.

A few other points from HealthCare.gov:

• Dental coverage is an essential health benefit for children, so it must be available when you get Marketplace coverage for a child (though you don't have to buy it).
• Adult dental coverage is not an essential health benefit, so health plans don't have to offer it.
• You can't buy a Marketplace dental plan unless you're also buying a Marketplace health plan.

Many people also get dental insurance through an employer, which can be a good deal if the employer pays part of the premium.

How a dental savings plan works

You pay a membership fee, usually monthly or yearly. You get a card. When you visit a dentist who participates in that plan, you pay a discounted price.

State insurance regulators are clear about what these plans are and aren't:

• The Texas Department of Insurance says discount health care programs are not insurance, and that the member is responsible for paying the full discounted cost.
• The Maryland Insurance Administration says discount plans may look like insurance but don't pay any of your health care costs, and that a discount plan card must state that it is not insurance.
• The Utah Insurance Department warns that a claim like "up to 40%" does not mean a guaranteed 40% savings, and that dentists in a network may stop offering the discount.

Because no insurer is paying claims, savings plans generally don't have the claim reviews that insurance does. That's why people often turn to them when they need work soon. But check the specific plan's terms yourself rather than assuming.

Side by side

Who each one tends to fit

Insurance may fit better if:

• An employer helps pay for it.
• You mostly need regular checkups and cleanings, and can plan bigger work after any waiting period.
• You're getting Marketplace coverage for a child, where dental coverage must be available.

A savings plan may fit better if:

• You need dental work soon and can't wait out a waiting period.
• A dentist you already want to see participates, and you've confirmed their discounted prices.
• You have no other dental coverage.

Neither may be the cheapest choice if:

• A dental school or community health center near you can do the work. Some school clinics charge well below private practice, and some don't accept insurance at all. The UT Health San Antonio student clinic, for example, says it does not accept dental insurance. Check the dental school clinics directory and HRSA's Find a Health Center first.
• You qualify for Medicaid or CHIP. NIDCR notes that states must cover dental care for children on Medicaid, and adult coverage varies by state.

Questions to ask before you buy either one

Adapted from the Utah Insurance Department's consumer checklist and HealthCare.gov's guidance:

1. Is this insurance or a discount plan?
2. Does my dentist participate right now? (Call the office and ask, don't rely only on a list.)
3. What will I actually pay for the treatment I need? Get prices in writing if you can.
4. Is there a waiting period, deductible or yearly limit?
5. How do I cancel, and is there a fee?
6. Is the company registered or licensed with my state's insurance department, if my state requires it?

The bottom line

Insurance shares the cost; a savings plan lowers the price. If you need work soon and your dentist participates, a savings plan can make sense. If an employer helps pay or you mostly need routine care, insurance may be the better deal. And if money is very tight, look at dental schools, health centers and Medicaid first. For urgent pain, see emergency dental care with no money.

Weighing pet insurance too? The same "read the exclusions and waiting periods" logic applies. Our sister site has a neutral guide: Is pet insurance worth it?

Note: Cheap Dentist Finder may earn a commission from some links on this site. See our affiliate disclosure. This guide does not recommend any specific plan.

Sources

1. HealthCare.gov, Dental coverage in the Marketplace
2. Texas Department of Insurance, Discount health care programs
3. Maryland Insurance Administration, What Consumers Need to Know About Discount Medical Plans
4. Utah Insurance Department, Health Discount Programs
5. NIDCR (NIH), Finding Dental Care
6. HRSA, Find a Health Center

Not medical advice. This guide is general information, not a substitute for a dentist or doctor. If you have facial swelling, a fever, or trouble breathing or swallowing, go to an emergency room or call 911.